En bloc explant with lift 1 year ago gone wrong, why are my breasts deformed? (Photos)

Your skin and breast tissue have thinned from having large implants for so long. The skin envelope needs more support in order to hold shape. A small implant with mesh support could help give you improved shape.

It’s completely understandable to feel disappointed when your surgical results don’t meet your expectations, especially after allowing a full year for healing and adjustments.
In cases of breast implant removal (en bloc explantation) after a long history of having implants—especially sizable implants (like 600cc)—it’s common for the skin and breast tissues to experience stretching and thinning. Once implants are removed, even with a lift, the remaining skin and breast tissues can struggle to retract fully, potentially causing unevenness, indentations, or irregularities.
Factors contributing to these issues typically include: • Skin Elasticity Loss: After many years with implants, the skin’s ability to shrink back can be diminished. • Capsular Contracture or Scar Tissue: This tissue, which forms naturally around implants, can leave behind irregularities even after careful explantation. • Residual Scar Tissue: Scars from previous surgeries, including explant and lift incisions, can contribute to an uneven appearance. • Tissue Atrophy: Long-term pressure from implants may lead to thinning of breast tissue and fat, affecting overall breast shape and volume.
Improvement is often possible with revision procedures, such as fat transfer, secondary breast lift (mastopexy), or even internal tissue repositioning. Non-surgical treatments, such as radiofrequency skin tightening, might offer slight improvements, but significant results typically require surgical revision.
Your best step forward is a detailed in-person assessment with a surgeon experienced specifically in post-explant reconstructive surgery. They’ll provide insights into your unique anatomy and help plan the most suitable next steps.
I hope this helps provide clarity on your situation. For a detailed assessment, consulting your surgeon would be beneficial.
— Güray Yeşiladalı, MD

Loss of Volume & Support
After removing large implants (especially 600cc), the remaining natural tissue may not have enough structure or elasticity to hold a full shape, even with a lift.

Over time, the skin and tissue can sag or collapse inward, creating a “deflated” or uneven appearance.

2. Tissue Thinning from Long-Term Implant Use
After 20 years with implants, especially large ones, your natural breast tissue likely thinned out. This makes it harder for the breast to regain a rounded shape once the implant is removed.

3. Chest Wall or Muscle Changes
Even though your surgeon said no muscle repair was needed, 20 years of dual-plane implants can change the positioning or function of the pectoral muscles.

A “window shading” effect or visible muscle movement might create odd shapes, dents, or shifting.

4. Capsular Contracture or Scarring
Even after an en bloc explant, internal scar tissue from your previous surgeries may remain and cause distortion.
Sometimes scar tissue pulls or puckers the skin in a way that becomes more visible over time.
5. Inadequate Lift or Technique
If the lift wasn’t aggressive enough to reshape and reposition the remaining tissue, or if skin quality was poor, the final result might look empty, sagging, or asymmetrical.
Also, your surgeon may have been conservative to avoid complications, which can lead to underwhelming aesthetic results.

Get a Second (or Third) Opinion
Preferably from a plastic surgeon with experience in revision and post-explant reconstruction.
Bring your surgical records and imaging if available — it helps them assess muscle, tissue, and implant history.
Consider Fat Grafting or Reconstructive Options
Fat transfer can restore volume in a more natural, subtle way.
Some women opt for smaller implants or internal mesh support (like GalaFLEX) if they want more shape without going back to large implants.
3D Imaging or Ultrasound
This can help assess any internal abnormalities, muscle separation, or scarring that might be affecting your outcome.